COVID-19?

Ring a-ring o’ roses,
A pocketful of posies.
A-tishoo! A-tishoo!
We all fall down!

Although now believed to be unlikely,  this verse was thought to have alluded to the great plague of 1665. 

I began writing this article months ago before any restrictions had been bought into place in Australia. Originally I was researching what to expect and how to prepare our funeral home and what was occurring throughout the world in funeral service. Eventually, I shelved the article as we seemed to be swamped with COVID overload. Although the COVID19 pandemic is by no means over I finally, decided to finish what I started to see where we have come from and what effects it has had on our industry.

February 2020

On 30 January 2020, the World Health Organization declared the coronavirus outbreak a Public Health Emergency of International Concern.

The Australian Government issued a health alert as a precaution, based on the latest and best medical advice.

Across the world

“Across the world, there have been about 82,704 confirmed cases of coronavirus (COVID-19) and 2,814 reported deaths. Of confirmed cases reported globally, the case fatality rate is approximately 3.4%. The case fatality rate in countries and regions outside mainland China is 1.4% (To put it in some perspective typical Australian Death rate is 7.3 deaths /1000 population (2018 est) or 0.0073%)

https://www.indexmundi.com/australia/death_rate.html

The majority of cases of COVID-19 have been reported from mainland China. 4,207 cases have been reported from 49 countries and regions outside mainland China. Since 27 February there have been 623 new cases and 14 deaths reported outside of mainland China.”

In Australia

As at 06:30 hrs on 28 February 2020, we have 23 confirmed cases of coronavirus (COVID-19) in Australia:

  • 8 in Queensland
  • 4 in New South Wales
  • 7 in Victoria
  • 3 in South Australia
  • 1 in Western Australia

15 of these cases are reported to have recovered. The remaining cases are in stable condition. 8 cases are passengers who were on the Diamond Princess repatriation flight from Japan. They were in quarantine at the Manigurr-ma Village Howard Springs facility in Darwin when they tested positive to coronavirus (COVID-19). All of these people have returned to their home states for medical treatment.

(Australian Government Department of HealthCoronavirus (COVID-19) health alert, 28/02/2020)

As the world struggles with the implications of the Coronavirus what are the implications for the Funeral Industry in Australia and Worldwide?

Hong Kong – Coronavirus outbreak leaves Hong Kong funeral homes facing coffin shortage. City’s industry supplied by factories in Guangdong

(South Chine Post, 23/02/2020)

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  • City’s industry supplied by factories in Guangdong that were ordered to close to stop the spread of the virus
  • Hong Kong government had to step in but only enough coffins left to last until the end of the month

The coronavirus crisis has led to a coffin shortage in Hong Kong after the outbreak stopped production over the border. Factories in Guangdong province were ordered to close until February 10 to contain the spread of the highly contagious virus, which causes the disease Covid-19.

The shortfall has triggered a warning from Hong Kong funeral parlours that stocks could dry up within days. Kwok Hoi-pong, chairman of the Funeral Business Association in Hong Kong, told the Post the temporary ban also covered the delivery of finished coffins to Hong Kong. According to Kwok, Guangdong accounts for 99 per cent of the coffins used in the city, and demand for them ranged from 120 to 140 per day. (MSN News.com)

Sichuan, China – Orders issued by China’s top health authority for the swift cremation of the remains of coronavirus victims at facilities near the hospitals where they died appear to be an overreaction and unnecessary to curb the transmission of the disease, top epidemiologists have said. The February 2 notice from the country’s National Health Commission requires hospitals to notify funeral parlours of the death along with family members but also states the procedure can be completed even if the family of the deceased does not agree.

(Al Jazeera, 09/02/2020)

The USA- In the United States States, National Funeral Directors Association (NFDA) has consulted with federal officials and embalming experts. At this time, they recommend that should an individual die from coronavirus, funeral home personnel who will come into contact with the body should use universal precautions. For more information, please see the CDC website with recommendations for healthcare providers – specifically, see section two, “Adherence to Standard, Contact, and Airborne Precautions, Including the Use of Eye Protection”

(National Funeral Directors Association, USA 26/02/2020)
Personal Protective Equipment is Vital
The wearing of personal protective equipment is vital equipment behind the scenes in the funeral industry
Containment of the body in a sealed bag
Body Bags appear to have been useful in containment after death

24th May 2020

Move forward to today, worldwide there are now over 5.28 million confirmed cases of COVID 19 and 340,000 deaths. Australia 7,106 Confirmed cases and 102 deaths.

The economic effects of COVID19 have been well documented. But, what effect has this had on the funeral industry?

Some have suggested that the industry has benefited from COVID deaths? Let me put this in perspective, Victoria has had 19 COVID19 related deaths, yet during the period January – March 2020 there have been 10,111 deaths (not related to COVID19) – Births Deaths and Marriages, Victoria. While still very sad for each of those families, the overall COVID19 figure has been very low, in relation to any effect on funeral service throughout the state.

When restrictions were bought into Australia the most significant changes to funeral service have been the restrictions on the number of mourners attending a funeral, originally only 10 persons this has now increased to 20 in our state. For many families, this has been extremely difficult in deciding who does and who does not attend the funeral service. There has been much said about live streaming and how this is the panacea to helping families. While it has assisted many families, the act of being there in person to support families is not lost on many.

IMG_5606 copy
Funeral Live Streaming

During this time of restriction, many families have made comments on how personal and private their funerals were and something they would consider in the future. Sadly, extended families and friends have not had this opportunity of saying farewell in the traditional way we know.

Many families have chosen not to have a service at all, with direct, or unattended cremation services on the increase. It is important to understand this type of cremation service has been on the increase for some time. Chosen for either cost or more commonly simplicity I think we can expect to see this continue to increase in popularity.

Perhaps this greatest effect has been on the closure of many of the alternate funeral venues, golf, bowls, yacht clubs have all been forced to close their doors. These are the places where contemporary funerals are held, where the focus is on family, friends and celebration of life. Usually mixed with food, drinks imagery and contemporary music. Civil celebrants, who often lead these types of services have often not been engaged throughout this period and have been noticeably quiet.

Thankfully many will be able to have memorial services in these locations when some sense of normality returns.

Although much was made about the lack of PPE(Personal Protection Equipment), sanitisers, body bags etc, the industry has copped relatively well and there now appears to be sufficient stocks available. Oddly, there have been anecdotal stories of some directors not carrying any PPE going into the COVID19 crisis, when indeed this forms part of funeral directors regular kit.

While there has been much written about the health care staff, internationally those countries and places with significant COVID19 related deaths have personally taken its toll on some funeral directors. Having to deal with large caseloads, restrictions on family visitations and even no attendance burials, many in the industry have struggled to cope with the personal impact and rapid changes this has all bought about.

The risks to funeral staff in Australia are still high. As we often enter aged care facilities, hospital and the like, protocols are now in place to register and record those entering and staff are normally temperature checked. The same cannot be said when entering private homes.

COVID19 is by no means over and as we continue to deal with new restrictions, protocols and procedures, we should be forever mindful of the human toll this has had on mankind.

Continue to take care.

Robert Nelson is a 5th generation funeral director with more than 3 decades in the funeral industry. He is the owner and managing director of Robert Nelson Funerals, based in Melbourne, Australia

 

When The Coroner Calls

A Coroner is a government official who is empowered to conduct or order an inquest into the manner or cause of death and to investigate or confirm the identity of an unknown person who has been found dead within the coroner’s jurisdiction. https://en.wikipedia.org/wiki/Coroner

Transfer is a funeral industry term to describe the process of moving a deceased person from one location to the next, typically from place of death to the funeral home.

“I would have been in my early to mid-teenage years when I did my first coroners transfer, it was during industry work strikes in the 1970s and I did them on my way to school. Memories of some transfers stay with you for life. One of my first, involved a small van with a gas bottle on the roof, slamming into a pole on a major road early one morning. The bottle exploded and the vehicle engulfed in flames. It’s not hard to imagine why these scenes are easily recalled many years later.”

With over 6500 (Coroner Court of Victoria, Annual Report 2017-2018) coronial investigations each year what determines when the coroner is involved and why?

The coroner deals with reportable death. There are the obvious types, Violent, unnatural or unexpected deaths, these include homicide, suicide and drug, alcohol and poison-related deaths.  Accident or injury-related deaths such as road fatalities, public transport fatalities, accidental falls, workplace deaths, electrocution, drowning and animal attacks. Where a person,s identity is unknown. The cause of death is not known (the medical practitioner cannot form an opinion about the probable cause of death). Healthcare-related deaths, when someone dies unexpectantly during or after a medical procedure. Deaths of a person who was in custody or care, an inpatient in a mental facility, under care or control of Victorian Police.

Warehouse workers after an accident in a warehouse.
An accident in a warehouse.
Fatal motorcycle accident
Automotive Fatalities

The death must be connected to Victoria, the body in Victoria, the death occurred in Victoria, The cause of death occurred in Victoria the person ordinarily resided in Victoria.

Given the large parameters under which death is reportable, it is not hard to see why there are so many cases handled by the Coroner. But why do the coroners investigate matters that to many people would appear to be straight forward and the deaths obvious?

The coroners court has three roles:

  1. Independently investigate deaths and fires
  2. Reduce preventable deaths
  3. Promote public health and safety and the administration of justice

Families first contact is often with a police officer who will inform the next of kin of the death. They will often seek additional information from the family which will be passed onto the coroner. The body is transferred to the Coronial Service Building in Southbank, Melbourne. All Victorian Coronial cases are transferred to this central location.

Whilst at the Coroners a number of things occur.

  • Identification, confirming the identity of the deceased, may involve visual, medical or scientific processes, including fingerprinting, dental records or blood or DNA.
  • Forensic Processes, the preliminary process may include, visual examination, collection of personal health information, the taking of bodily fluids, imaging such as CT, Xrays and ultrasound and fingerprints.  Often an autopsy (post mortem) is requested. This is performed by a pathologist using techniques similar to a surgical operation. During this process, the major organs of the body are removed and examined and specimens are taken for analysis. The benefit of an autopsy is that it can provide detailed information about the person’s health and condition to give an understanding of the various factors that may have contributed to their death. Even if the cause of death seems clear, the person may have had a medical condition that was not obvious during their life. A family has the right and can request an objection to an autopsy.
Medical Research
Forensic Scientific Investigations
Blood test tubes in centrifuge. Medical laboratory concept.
Body Fluid Testing

Once all the investigations are complete the coroner will issue an “Order for Release”, this enables the body to be released to a funeral director and the funeral performed. Unlike deaths that are not reportable, the full death certificate can take some time before the cause of death is actually known. Your funeral director will guide you and can order an Interim Death Certificate. These look just like a regular death certificate but does not contain the cause of death. Once the coroners office has provided the cause of death to Births Deaths and Marriages a Full Death Certificate can be issued. This can take several months.

Why do some of these processes take so long? With over 6600 investigations each year, the average time to investigate takes 11.8 months? While many associates the coroners with inquests, out of 6500 investigations only 49 inquests were held over that same period of time.

Typically a families involvement with the coroner will be unexpected, it is not one of those things anyone would expect. Your Funeral Director is the best person to contact. They have regular and consistent contact with the coroners office and will arrange for the release of the deceased into their care. Funeral arrangments can occur before the body is released. The body can be expected to remain in their care anywhere from several days to several weeks.

The sudden death of a partner, child family member or friend can be a difficult and painful experience. Families can be assured that today,  Victorias Coronial Services Centre is one of the world leaders in Forensic medicine. The practices of yesteryear have long gone, replaced with state of the art facilities and highly trained professionals and skilled staff.

For more information, https://www.coronerscourt.vic.gov.au

Robert Nelson is a 5th generation funeral director with more than 3 decades in the funeral industry. He is the owner and managing director of Robert Nelson Funerals.

 

 

An Hour On The Day…. Hardly!

The funeral was only 20 minutes away from commencing and my new colleague turned to me and asks, “are you nervous because I am”. I turned to her and said, “no,  I’m OK”, I lied.

I met Fred’s  (not his real name) family almost a week before, he was terminally ill and had a young family. Fred was in his last days of life. His family had somewhat come to terms with this and were quietly calm in talking about him. Naturally, at times they would need time to compose themselves as they were coming to grips with the finality of his life.

We spoke about what type of funeral service Fred and his family might like and his preference for burial or cremation. We discussed funeral venues and styles of services. I was beginning to get a picture of what the family wanted to do. There would be quite a lot of family travelling from interstate and some from overseas. We left fairly open the choices and would finalise the details when Fred died. But, given Fred’s long illness, the family were keen to ensure the funeral was held quite quickly.

Fred died two days later.

Robert nelson Funerals
Robert Nelson Funerals

All of a sudden there was a greater sense of urgency by Freds family in organising the funeral. We took Fred,s body into our care and organised all of the appropriate certificates from his attending doctor.  A suitable celebrant was selected that we felt would bond well with his family, Coffins, flowers, service time and date for the funeral were all set. There was to be refreshments and catering including an open bar at the venue. The hourglass was now turned and we were on a fixed time to have everything in place for that “hour on the day”.

Over the next few days, there would be dozens of communications, in person, by phone and email conveying all the necessary information to ensure everything went to plan.

Remember how I started this piece when asked if I was nervous just before the funeral, well, it is about this time when I am the most nervous, knowing we have a great deal to achieve and with a limit on the time to do it. There is a golden rule, Plan, Plan, Plan, Plan and then expect things to go wrong and plan for that too. Everything needs a backup plan, so we can expect the unexpected and deal with it even at the last minute.

Behind the scenes, Freds body needs to be prepared and dressed as the family wants to see him the night before the funeral. The coffin has been ordered and delivered and we now have Freds clothing, preparation will take 1-2hrs by skilled qualified staff. The Government Medical officer had visited our mortuary at 2am the night before to finalise cremation documentation. It’s all go, go , go.

Our in house Audiovisual specialist is busy preparing video tributes for the service and the wake following. with over 125 images and 16 tracks of music for the service and wake, there were many hours of work into the night ahead. the service would also be video recorded, so there was a stack of gear we would also be taking along. This is also unpacked, checked and repacked to go.

Audio Visual
Audio Visual

As we neared the day of the funeral, numbers still had to be finalised for the wake at the venue. What had started out as 60 people had now grown to 125? It’s impossible to guess the actual number of people that will attend, but there is always sufficient food to cover another 50 or more. People don’t generally come for lunch.

By this time our celebrant had met with the family and formed an order for the service now only 48 hours away. She would be in regular contact with them over the following days. The sand in that hourglass was running low.

The family hadn’t yet organised the printed order of service  and there was still a potential that we may have to do it at the last moment. Remember Plan and plan for the unexpected.

The family arrived the night before the funeral to see Fred, they were no doubt very sad but pleased they could say their last goodbyes. They advised the order of service was in hand and all would be ready by tomorrow.

The following morning flowers arrived at 4.30am and we arrived at 6am to get the vehicles prepared for the 2pm service. To my aghast, the flowers weren’t quite right. A quick call to our florist and a pick up from the local wholesaler and we were back on track.

Coffin Flowers
Flowers by Gradiflora

All of the audiovisual had been triple checked the night before, but a laptop was left running and you guessed it was doing a new software install. Now, really! Sure enough, it loaded on time and we were now back on track, but now almost no sand left in our hourglass.

With all the gear packed and the hearse carrying Fred all clean and shiny, it was time to head off to the venue, some two hours before the start of the funeral. There was much to set up. On arrival, gear unloaded, set up, venue staff briefed and one hour left before service time, there is now no time to be nervous, we have planned, tested, planned, tested everything.

There were hundreds turn up to Freds funeral. The family loved everything, as much as you can at a funeral. At the conclusion of the service, family and friends stayed behind to chat and have refreshments. we still had Fred to deliver to the crematorium. I would later return to ensure everything was still going well. At 5pm many of the mourners had now left the venue, yet there were still many interstate friends and relatives. A few quick discussions with the venue team and I had another room within the venue sorted and the wake would continue on for many hours to come.

Springvale Botanical Cemetery - Function Rooms
Springvale Botanical Cemetery – Function Rooms

I arrived home, about 8pm a little tired and with a slight smile, maybe of relief that everything had gone to plan and the family happy with our services.

Was it a hectic week for us, possibly, but what I didn’t tell you is we also dealt with a number of other families at the same time. It matters not to them, that we have other families or clients, everyone is special and everyone deserves to treated like they are the only person we are dealing with.

Next time you see us for that hour on the day, remember our day may have started days ago.

Robert Nelson is a 5th generation Funeral Director. His company Robert Nelson Funerals is based in Moorabbin, Victoria, Australia. He provides Meaningful, Affordable Funerals across Melbourne and the Mornington Peninsula.